Opportunities for States to Promote Financial Integration for Dual-Eligible Individuals

By: Anthony J. Fiori | Stephanie Anthony | Lori Houston-Floyd
– Health Affairs

Manatt Health Senior Managing Director Anthony Fiori, Senior Advisor Stephanie Anthony and Senior Manager Lori Houston-Floyd co-authored an article for Health Affairs based on a report prepared with the support of Arnold Ventures discussing how states can improve the financial integration of Medicare and Medicaid for dual-eligible individuals. The article focuses on strategic benefit design and Medicaid rate-setting for Fully Integrated Dual-Eligible Special Needs Plans (FIDE-SNPs), and how these strategies can help states expand access to and grow enrollment in these integrated care models.  

In the article, the authors explored these opportunities under existing Medicare and Medicaid program rules. They explained how states can leverage these strategies to improve the experience and outcomes for beneficiaries and allow states to share in the savings accruing to Medicare from Medicaid investments. Only a handful of states are deploying these strategies, however, and they noted that additional guidance and technical assistance from the Centers for Medicare and Medicaid Services (CMS) would help them operationalize these opportunities. “With a greater understanding of these strategies and additional guidance from CMS, more states may pursue FIDE-SNP models of integrated care in an effort to better align Medicare and Medicaid financing and provide a more seamless experience of care for dual-eligible individuals,” they concluded. 

Read the complete Health Affairs article here.  



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